'Polypill' could slash heart attacks and strokes

A wonder pill that could slash the rate of deaths from heart attack or stroke by over 80 per cent is being proposed by UK researchers.

The "Polypill" would contain a cocktail of six existing drugs and should be given to everybody over the age of 55, the researchers argue. It could potentially save 200,000 lives every year in the UK alone, they say.

"There's probably no other preventative measure which would have greater impact on public health in the Western world," says Nicholas Wald, research leader and an expert in preventative medicine at the Wolfson Institute of Preventive Medicine, London.

"In people who start taking it at 55, about a third would expect to benefit," he says. "Each of these individuals would gain about 12 years extra life - that is enormous." In some cases the increase in longevity might be as much as 20 years, says the proposal.

"This is extremely important," says Richard Smith, editor of the British Medical Journal, which released three papers by Wald's group on Thursday. "Heart attack and stroke kill half of the British population." Smith suggested that the BMJ issue in which the proposals appear might be the most important for 50 years.

Key risk factors

The proposal is underpinned by a massive analysis of earlier trials of drugs that can lower different aspects of the risk of cardiovascular disease. Over 750 trials involving 400,000 people were assessed. However, the "Polypill" has yet to be tested in any clinical trials.

The pill would combine different drugs to try to lower the four key risk factors for heart disease: cholesterol, high blood pressure, high homocysteine blood levels and blood platelet function.

A statin would reduce high levels of the "bad" LDL cholesterol, slashing the risk of heart disease, while three blood pressure lowering drugs would reduce stroke risk, says Wald.

Folic acid in the pill would cut high homocysteine levels, which can encourage the build up of fatty plaques in arteries. And finally aspirin would be added to regulate the function of blood platelets. Overall, the wonder pill would cut the risk of heart disease by 88 per cent and stroke by 80 per cent, the scientists estimate.

The pill could also be produced cheaply, says Wald, as the patents on many of the components have expired or will do soon.

Little to lose

Eventually the drug could be given to everyone over 55, without requiring a medical examination, says Wald. He believes that age is a more powerful predictor of cardiovascular disease than the risk factors usually considered. "In Western society, the risk factors are high in us all, so everyone is at risk," he says. "There is much to gain and little to lose by the widespread use of these drugs."

Rory Collins, a British Heart Foundation professor of medicine and epidemiology at Oxford University told New Scientist he supports the Polypill concept, noting the idea has been mooted before.

"I think, in principle, it would produce substantial reductions in risk," says Collins, leader of the UK Heart Protection Study. "The idea is a perfectly sensible one in that the effect of these treatments do appear to be largely independent of one another."

Wald and colleagues are planning a small trial examining combinations of blood pressure lowering drugs for use in the Polypill. But he says clinical trials of the pill itself may be "tricky" as pharmaceutical companies are unlikely to be keen on funding the development costs of a pill containing off-patent drugs.

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